Skip to main content
Erschienen in: Supportive Care in Cancer 12/2015

01.12.2015 | Original Article

Head and neck cancer patients’ perceptions of swallowing following chemoradiotherapy

verfasst von: Joanne M. Patterson, Elaine McColl, Janet Wilson, Paul Carding, Tim Rapley

Erschienen in: Supportive Care in Cancer | Ausgabe 12/2015

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The study aims to describe patients’ experiences of swallowing difficulties following (chemo)radiotherapy for head and neck cancer and to explore any changes over time.

Methods

A purposive sample of patients with swallowing difficulties was selected at a range of time points, from 3 to 18 months following treatment. Ethnographic observations of 12 patients were conducted in their own homes, over a mealtime situation. Nine new patients were interviewed about changes to their eating and drinking from pre- to post-treatment. Thematic analysis was used to code and analyse the data.

Results

Patients’ reports of swallowing function were divided into four time zones: pre-treatment, during radiotherapy, early (0–3 months) and late (6–18 months) time points following treatment. The majority reported minimal problems at diagnosis, but marked impairment during and after radiotherapy, without a return to pre-treatment functioning. The focus was on severe physical side effects and changes to food preparation during radiotherapy and in the early phase of recovery. By 6 months, side effects began to subside, but swallowing was still difficult, leading to major changes to family life, socialisation and lifestyle.

Conclusions

Swallowing problems after (chemo)radiotherapy are multi-faceted and highly individualised and restrict lives in the long term. Swallowing ability may improve in time, but does not appear to return to pre-treatment function. Further work is required to find ways of being able to best support patients living with this long-term condition.
Literatur
1.
Zurück zum Zitat Wilson JA, Carding PN, Patterson JM (2011) Dysphagia after nonsurgical head and neck cancer treatment: patients’ perspectives. Otolaryngol Head Neck Surg 145:767–771CrossRefPubMed Wilson JA, Carding PN, Patterson JM (2011) Dysphagia after nonsurgical head and neck cancer treatment: patients’ perspectives. Otolaryngol Head Neck Surg 145:767–771CrossRefPubMed
2.
Zurück zum Zitat Gillespie MB, Brodsky MB, Day TA et al (2005) Laryngeal penetration and aspiration during swallowing after the treatment of advanced oropharyngeal cancer. Arch Otolaryngol Head Neck Surg 131:615–619CrossRefPubMed Gillespie MB, Brodsky MB, Day TA et al (2005) Laryngeal penetration and aspiration during swallowing after the treatment of advanced oropharyngeal cancer. Arch Otolaryngol Head Neck Surg 131:615–619CrossRefPubMed
3.
Zurück zum Zitat van der Molen L, van Rossum MA, Ackerstaff AH et al (2009) Pretreatment organ function in patients with advanced head and neck cancer: clinical outcome measures and patients’ views. BMC Ear Nose Throat Disord 9:10PubMedCentralCrossRefPubMed van der Molen L, van Rossum MA, Ackerstaff AH et al (2009) Pretreatment organ function in patients with advanced head and neck cancer: clinical outcome measures and patients’ views. BMC Ear Nose Throat Disord 9:10PubMedCentralCrossRefPubMed
4.
Zurück zum Zitat Campbell BH, Spinelli K, Marbella AM et al (2004) Aspiration, weight loss, and quality of life in head and neck cancer survivors. Arch Otolaryngol Head Neck Surg 130:1100–1103CrossRefPubMed Campbell BH, Spinelli K, Marbella AM et al (2004) Aspiration, weight loss, and quality of life in head and neck cancer survivors. Arch Otolaryngol Head Neck Surg 130:1100–1103CrossRefPubMed
5.
Zurück zum Zitat Edwards D, Edwards D (1998) Head and neck cancer services: views of patients, their families and professionals. Br J Oral Maxillofac Surg 36:99–102CrossRefPubMed Edwards D, Edwards D (1998) Head and neck cancer services: views of patients, their families and professionals. Br J Oral Maxillofac Surg 36:99–102CrossRefPubMed
6.
Zurück zum Zitat Pollock K, Cox K, Howard P et al (2008) Service user experiences of information delivery after a diagnosis of cancer: a qualitative study. Support Care Cancer 16:963–973CrossRefPubMed Pollock K, Cox K, Howard P et al (2008) Service user experiences of information delivery after a diagnosis of cancer: a qualitative study. Support Care Cancer 16:963–973CrossRefPubMed
7.
Zurück zum Zitat Brockbank S, Miller N, Owen S, Patterson JM (2014) Pre-treatment information on dysphagia: exploring the views of head and neck cancer patients. J Pain Symp Manag Brockbank S, Miller N, Owen S, Patterson JM (2014) Pre-treatment information on dysphagia: exploring the views of head and neck cancer patients. J Pain Symp Manag
8.
Zurück zum Zitat Lang HD, France E, Williams B et al (2013) The psychological experience of living with head and neck cancer: a systematic review and meta-synthesis. Psycho-Oncology 22:2648–2663CrossRefPubMed Lang HD, France E, Williams B et al (2013) The psychological experience of living with head and neck cancer: a systematic review and meta-synthesis. Psycho-Oncology 22:2648–2663CrossRefPubMed
9.
Zurück zum Zitat Roing M, Hirsch J-M, Holmstrom I (2008) Living in a state of suspension—a phenomenological approach to the spouse’s experience of oral cancer. Scand J Caring Sci 22:40–47CrossRefPubMed Roing M, Hirsch J-M, Holmstrom I (2008) Living in a state of suspension—a phenomenological approach to the spouse’s experience of oral cancer. Scand J Caring Sci 22:40–47CrossRefPubMed
10.
Zurück zum Zitat Richardson A, Lee L, Birchall M et al (2002) Learning from patients with cancer and their spouses: a focus group study. J Laryngol Otol 116:1028–1035CrossRefPubMed Richardson A, Lee L, Birchall M et al (2002) Learning from patients with cancer and their spouses: a focus group study. J Laryngol Otol 116:1028–1035CrossRefPubMed
11.
Zurück zum Zitat Scott SE, Grunfeld EA, Main J et al (2006) Patient delay in oral cancer: a qualitative study of patients’ experiences. Psycho-Oncology 15:474–485CrossRefPubMed Scott SE, Grunfeld EA, Main J et al (2006) Patient delay in oral cancer: a qualitative study of patients’ experiences. Psycho-Oncology 15:474–485CrossRefPubMed
12.
Zurück zum Zitat Molassiotis A, Rogers M (2012) Symptom experience and regaining normality in the first year following a diagnosis of head and neck cancer: a qualitative longitudinal study. Palliat Support Care 10:197–204CrossRefPubMed Molassiotis A, Rogers M (2012) Symptom experience and regaining normality in the first year following a diagnosis of head and neck cancer: a qualitative longitudinal study. Palliat Support Care 10:197–204CrossRefPubMed
13.
Zurück zum Zitat Roing M, Hirsch JM, Holmstrom I (2007) The uncanny mouth—a phenomenological approach to oral cancer. Patient Educ Couns 67:301–306CrossRefPubMed Roing M, Hirsch JM, Holmstrom I (2007) The uncanny mouth—a phenomenological approach to oral cancer. Patient Educ Couns 67:301–306CrossRefPubMed
14.
Zurück zum Zitat Nund RL, Ward EC, Scarinci NA et al (2014) The lived experience of dysphagia following non-surgical treatment for head and neck cancer. Int J Speech Lang Pathol 16:282–289CrossRefPubMed Nund RL, Ward EC, Scarinci NA et al (2014) The lived experience of dysphagia following non-surgical treatment for head and neck cancer. Int J Speech Lang Pathol 16:282–289CrossRefPubMed
15.
Zurück zum Zitat Larsson M, Hedelin B, Athlin E (2003) Lived experiences of eating problems for patients with head and neck cancer during radiotherapy. J Clin Nurs 12:562–570CrossRefPubMed Larsson M, Hedelin B, Athlin E (2003) Lived experiences of eating problems for patients with head and neck cancer during radiotherapy. J Clin Nurs 12:562–570CrossRefPubMed
16.
Zurück zum Zitat Shragge JE, Wismer WV, Olson KL, Baracos VE (2007) Shifting to conscious control: psychosocial and dietary management of anorexia by patients with advanced cancer. Palliat Med 21:227–233CrossRefPubMed Shragge JE, Wismer WV, Olson KL, Baracos VE (2007) Shifting to conscious control: psychosocial and dietary management of anorexia by patients with advanced cancer. Palliat Med 21:227–233CrossRefPubMed
17.
Zurück zum Zitat Martino R, Beaton D, Diamant NE (2010) Perceptions of psychological issues related to dysphagia differ in acute and chronic patients. Dysphagia 25:26–34CrossRefPubMed Martino R, Beaton D, Diamant NE (2010) Perceptions of psychological issues related to dysphagia differ in acute and chronic patients. Dysphagia 25:26–34CrossRefPubMed
18.
Zurück zum Zitat McQuestion M, Fitch M, Howell D (2011) The changed meaning of food: physical, social and emotional loss for patients having received radiation treatment for head and neck cancer. Eur J Oncol Nurs 15:145–151CrossRefPubMed McQuestion M, Fitch M, Howell D (2011) The changed meaning of food: physical, social and emotional loss for patients having received radiation treatment for head and neck cancer. Eur J Oncol Nurs 15:145–151CrossRefPubMed
19.
Zurück zum Zitat Semple CJ, Dunwoody L, George Kernohan W et al (2008) Changes and challenges to patients’ lifestyle patterns following treatment for head and neck cancer. J Adv Nurs 63:85–93CrossRefPubMed Semple CJ, Dunwoody L, George Kernohan W et al (2008) Changes and challenges to patients’ lifestyle patterns following treatment for head and neck cancer. J Adv Nurs 63:85–93CrossRefPubMed
20.
Zurück zum Zitat Patterson JM, McColl E, Carding PN et al (2015) Swallowing in the first year after chemoradiotherapy for head and neck cancer: Clinician-and patient-reported outcomes. Head Neck 2013 Patterson JM, McColl E, Carding PN et al (2015) Swallowing in the first year after chemoradiotherapy for head and neck cancer: Clinician-and patient-reported outcomes. Head Neck 2013
21.
Zurück zum Zitat Hammersley MP A (1995) Ethnography: principles in practice. Routledge, London Hammersley MP A (1995) Ethnography: principles in practice. Routledge, London
22.
Zurück zum Zitat Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3:77–101CrossRef Braun V, Clarke V (2006) Using thematic analysis in psychology. Qual Res Psychol 3:77–101CrossRef
23.
Zurück zum Zitat Sandelowski M (2000) Whatever happened to qualitative description? Res Nurs Health 23:334–340CrossRefPubMed Sandelowski M (2000) Whatever happened to qualitative description? Res Nurs Health 23:334–340CrossRefPubMed
24.
Zurück zum Zitat Neergaard MA, Olesen F, Andersen RS, Sondergaard J (2009) Qualitative description—the poor cousin of health research? Bmc Med Res Methodol (9) Neergaard MA, Olesen F, Andersen RS, Sondergaard J (2009) Qualitative description—the poor cousin of health research? Bmc Med Res Methodol (9)
25.
Zurück zum Zitat Miles MB, Huberman AM (1984) Qualitative data analysis: a sourcebook of new methods. Sage, Newbury Park Miles MB, Huberman AM (1984) Qualitative data analysis: a sourcebook of new methods. Sage, Newbury Park
26.
Zurück zum Zitat Wells M (1998) The hidden experience of radiotherapy to the head and neck; a qualitative study of patients after completion of treatment. J Adv Nurs 28:840–848CrossRefPubMed Wells M (1998) The hidden experience of radiotherapy to the head and neck; a qualitative study of patients after completion of treatment. J Adv Nurs 28:840–848CrossRefPubMed
27.
Zurück zum Zitat Rose-Ped AM, Bellm LA, Epstein JB et al (2002) Complications of radiation therapy for head and neck cancers—the patient’s perspective. Cancer Nurs 25:461–467CrossRefPubMed Rose-Ped AM, Bellm LA, Epstein JB et al (2002) Complications of radiation therapy for head and neck cancers—the patient’s perspective. Cancer Nurs 25:461–467CrossRefPubMed
28.
Zurück zum Zitat Roing M, Hirsch JM, Holmstrom I, Schuster M (2009) Making new meanings of being in the world after treatment for oral cancer. Qual Health Res 19:1076–1086CrossRefPubMed Roing M, Hirsch JM, Holmstrom I, Schuster M (2009) Making new meanings of being in the world after treatment for oral cancer. Qual Health Res 19:1076–1086CrossRefPubMed
29.
30.
Zurück zum Zitat Hutcheson KA, Lewin JS, Barringer DA et al (2012) Late dysphagia after radiotherapy-based treatment of head and neck cancer. Cancer 118:5793–5799PubMedCentralCrossRefPubMed Hutcheson KA, Lewin JS, Barringer DA et al (2012) Late dysphagia after radiotherapy-based treatment of head and neck cancer. Cancer 118:5793–5799PubMedCentralCrossRefPubMed
Metadaten
Titel
Head and neck cancer patients’ perceptions of swallowing following chemoradiotherapy
verfasst von
Joanne M. Patterson
Elaine McColl
Janet Wilson
Paul Carding
Tim Rapley
Publikationsdatum
01.12.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 12/2015
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-015-2715-8

Weitere Artikel der Ausgabe 12/2015

Supportive Care in Cancer 12/2015 Zur Ausgabe

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.